Medical Jurisprudence And Toxicology

526 MEDICAL JURISPRUDENCE

12. Novasurol (Merbaphen),—This is a double salt of sodium mercuri-
chlorphenyl oxyacetate with diethyl-barbituric acid. It is a white, crystal-
line powder, soluble in water, and contains 33.9 per cent of mercury. It is
a powerful diuretic, the dose being J to 2 cc. of a 10 per cent solution by
intravenous or intramuscular injection.

13. Mersalylum (Mersalyl, Salyrgan, Mercurgan).—This is a sodium
salt of salicyl-(Y-hydroxymercuri-B-methoxypropyl)-amide-o-acetic acid. It
is a white, odourless, deliquescent powder, having a bitter taste, and con-
taining 38.5 to 40.5 per cent of mercury. It dissolves in water, inv alcohol
(95 per cent) and in methyl alcohol. Injectio Mersalyli is a pharmacopoeia!
preparation, the dose being 8 to 30 minims by intramuscular or intravenous
injection.

14. Merairodhrome-220 (Disoditun Dibromo-hydroxy-mercuri Flu-
orescein), C2oH7O5Br2 HgOHNa2.—This is also known as mercurome, and
occurs as iridescent green scales, and dissolves readily in water. It contains
25 to 28 per cent of mercury. It has been used intravenously in cystitis,
gonorrhoea, articular rheumatism, endocarditis, and septicaemic conditions.
The dose is 0.002 to 0.005 gramme per kilogramme of body weight in a 0.5
per cent solution by intravenous injection. Ten milligrammes per kilo-
gramme of body weight given intravenously kill rabbits. Five milligrammes
per kilogramme of body weight in a 1 per cent solution have been injected in-
travenously twice a week without trouble in several cases.01 GJP.B. Huddy52
treated 29 adult patients with mercurochrome after operation with a view
to preventing the onset of post-operative pneumonia. He injected intra-
venously 20 cc. of a 1 per cent solution immediately following an operation,
and 10 cc. of a similar solution two days later. Reaction started in 10
patients after the second injection. This suggests that the drug may be
cumulative. The most common reaction consisted of a rigor with a rise of
temperature to about 102°F. In one case there was blood in the urine and
stools, and in another case there was a severe rigor with headache, cyanosis ,
and collapse.

Toxic effects have occurred mostly after the prolonged use of the drug
in fairly large doses. A. V. St. George53 reports that death followed the
intravenous injection of a 1 per cent solution in five cases of sepsis. Post-
mortem examination showed that it induced nephritic and intestinal lesions
which resulted in death.

The other organic mercurial preparations are neptal, thiomerin sodium
(mercaptomerin sodium), metaphen and merthiolate (thioniersalate), Of
these four the first two are used as diuretics and are supposed to have low'
toxicity in therapeutic doses, and the latter two are used as antiseptics for
sterilizing the skin and instruments.

Acute Poisoning.—Symptoms.—The symptoms are mostly due to cor-
rosive sublimate, and commence immediately after swallowing the poison.
They are rarely delayed beyond half an hour, although in a case reported by
Wood,54 the symptoms were delayed one hour and a half. These are^ am
acrid, metallic taste and a "feeling of constriction or choking sensation in the I
throat,"' hoarse voice- and difficult breathing.' The mouth, tongue and fauces
become corroded, swollen and coated with a ^greyish-white coating. Hot
burning pain is felt in the mouth, extending downBT^ abdo-

men, followed by nausea, retching and vomiting. The vomited matter is a
greyish, slimy mucoid material containing blood and shreds of mucous

51. Joseph O'Carroll, Lancet, Dec. 31, 1927, p. 1416.

52. Lancet, Ibid.

53. Jour. Amer. Meet. Assoc,, Dec, 26, 1925, p. 2005

54. Jour. Amer. Med. Assoc.s 1915, LXIV, p. 507.